The draft consensus statement is out and underscores the uncertainty behind the diagnosis of Alzheimer's and theories on prevention of Alzheimer's and,more generally, any cognitive decline. Some excerpts from the Conclusions portion of the draft statement:
The level of uncertainty expressed seems appropriate to me. The level of complexity of definitions and risk factors makes me wonder how successful any scientific studies can be.
The panel is taking public comment this morning, then will issue a final statement at 2 pm eastern today.
In yesterday’s presentations and discussions, some researchers noted that they use the term Alzheimer’s to refer to Alzheimer’s pathologies (plaques and tangles) but also to a set of symptoms which, at least in old age, is commonly caused by a number of pathologies. This can be confusing, at least to laypeople.
This came up again today, with Ron Petersen of the Mayo Clinic noting that not separating the syndrome from the underlying pathology caused trouble yesterday. In response to a question from a panel member about diagnosing people with biomarkers when there’s no good treatment and when there would be psychological and financial implications, Dr. Petersen said he endorsed this concern, especially with respect to the role of amyloid biomarkers. “All they tell us is about the presence or absence of cerebral amyloidosis, which may not equal Alzheimer’s disease,” he said. These tests are valuable to have as indices in the clinical picture, but it’s very different to say they mean someone has Alzheimer’s, he added.
The Alzheimer's Society has released a new report based on interviews of 44 people with dementia. The report concludes that people with dementia can have a good quality of life, and highlights what factors are most important in determining that quality.
My friends with early stage memory loss are among my best personal advisors. They seem to have a way of getting to the heart of a matter, and understanding what’s important.
They might be able to give advice to a variety of people through the Elder Wisdom Circle (EWC), an online site where anyone can ask for personal or career advice, and get a free, private response via email. Requests for advice are assigned to the most appropriate volunteer or group of volunteers among a pool of 600 “elders,” age 60 to 105.
The work is done through the Elder Wisdom Circle’s online system, says founder Doug Meckelson. If you’re not confident you can navigate an online system, you may still be able to volunteer.
Summary: Results of a clinical trial of Axona show the medical food may be an effective treatment for people with mild to moderate Alzheimer’s, at least for those who don’t have the APOE4 genetic variation. Accera is planning a larger trial to confirm these results.
The company is also planning an imaging study to try to prove that treatment with Axona changes the metabolism of certain areas of the brain, and that those changes are linked with improvements in cognition. If successful, Accera could be among the first to show that changes to a “biomarker” reflect real changes in memory and thinking.
I’ve written before about Accera’s Axona, a medical food available by prescription for people diagnosed with mild to moderate Alzheimer’s. The theory behind Axona is that if brain cells aren’t getting or using enough glucose, you can substitute ketone bodies for glucose. A ketone body is a substance created when fats are broken down in the body. Axona increases the level of ketone bodies in the blood, and in theory, provides an alternate fuel for brain cells.
Last week, I talked with Steve Orndorff, President and CEO of Accera, to get an update on his company’s product. Data from an initial trial of Axona have now been published, and the results are encouraging enough for Accera to plan a larger clinical trial, he says.
Researchers at Massachusetts General Hospital and their colleagues have reported that the beta amyloid protein that makes up Alzheimer’s plaques can reduce the growth of several types of bacteria and a yeast, all of which cause infections in the brain.
If the drug reduces amyloid in the brain, but doesn’t affect symptoms, we’re bound to hear a lot of questions about the strategy of reducing amyloid to prevent or treat dementia.
Note: Elan has sold the rights to bapineuzumab to Janssen Alzheimer Immunotherapy, but now owns part of that company.